We carried out an announced focussed inspection at Lea Vale Medical Practice on 18 February 2020 as part of our inspection programme.
We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:
- Effective
- Responsive
- Well-led
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as outstanding overall and for the Families, children and young people and People whose circumstances make them vulnerable population groups. They are rated as good for the population groups Older people, People with long term conditions and People experiencing poor mental health (including people with dementia) and requires improvement for Working age people (including those recently retired and students).
We rated the practice as good for providing effective services because:
- Actions had been taken to improve the uptake of baby immunisations and cervical screening.
- Recommended training and appraisals had been completed for all staff.
- Clinical audits were undertaken to demonstrate quality improvement.
- Performance data showed the practice was comparable with others both locally and nationally.
- The uptake rate for cervical screening was below the 80% NHS England target.
We rated the practice as outstanding for providing responsive services because:
- The care delivered to the families, children and young people population group was focussed on education for their health needs. A Parent’s Guide to Health tool had been developed and adopted by two local schools.
- The practice recognised the needs of vulnerable people by providing a specific registration process for homeless people that considered medicine reviews and appropriate referrals to secondary care. They worked with a local bail hostel to register patients newly released from prison and ensure they received a medicines review to ensure they had appropriate prescribing and supply of medicines.
- The practice had developed a clinical team of different skill mixes to meet the needs of their patients. This included paramedics, pharmacists, physician associates and nurses in addition to GPs.
- Evening and weekend appointments were available.
- The practice had responded to patient feedback regarding telephone access and had implemented measures to make improvements that included a new telephone system, a dedicated call centre, web chat facility on the practice website and a call back facility.
The practice is rated as outstanding for providing well-led services because:
- The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
- They had developed a partnership and clinical model to reflect the needs of their patients that included different skill mixes.
- The well-being of staff was supported by the use of flexible and homeworking, a well-being counsellor and improvements to terms and conditions.
- Staff views and suggestions were actively used to make improvements to services within the practice.
- The practice contributed to national learning by sharing their clinical and partnership models with other practices. They had created educational videos with NHS England that were available on video sharing websites and were finalists of The GP Practice Team of the Year in 2018.
- The practice worked with local providers and stakeholders to design a pilot to reduce opioid prescribing.
- The practice had developed a bespoke counselling service that allowed patients referred for counselling to be seen in their own homes.
Whilst we found no breaches of regulations, the provider should:
- Continue to take actions to increase the uptake of cervical screening and baby immunisations.
- Continue to develop the Patient Participation Group.
- Monitor patient satisfaction in response to the changes made to improve access to the practice via the telephone.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care